Hammond Elizabeth Andersen, Pitz Marshall, Lambert Pascal, Shay Barbara
College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Internal Medicine, Rady Faculty of Health Sciences, Medical Oncologist, University of Manitoba, Winnipeg, Manitoba, Canada.
Can J Pain. 2019 Oct 3;3(1):169-177. doi: 10.1080/24740527.2019.1665992. eCollection 2019.
: The aim of this study was to define the sensory phenotypes of taxane-induced peripheral neuropathy (TIPN) between neuropathic and nonneuropathic symptoms in a breast cancer population to identify future targets for mechanism-based pain management. : Participants ( = 48) with stage I-III breast cancer. Self-report questionnaires and quantitative sensory testing were used to assess sensory symptoms. The self-report version of the Leeds Assessment for Neuropathic Symptoms and Signs (S-LANSS) divided the groups into neuropathic and nonneuropathic sensory phenotypes. In total, five visits over approximately 8 months assessed each participant from pre-chemotherapy to 6 months post-chemotherapy. : Out of 191 nerve assessments, 150 had an S-LANSS <12 defined as "nonneuropathic" and 41 scored >12, which was defined as "neuropathic." Numeric Pain Rating Scale (NPRS) was analyzed based on percentages of those experiencing 1+ pain (graded 1/10 or higher) versus no pain. The neuropathic group had 82.9% of 1+ pain vs. 28.7% in the nonneuropathic group (odds ratio = 7.49; 95% confidence interval, 2.76-20.3; = 0.001). The neuropathic group reported impaired function on the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire ( = 0.002). Heat pain threshold resulted in statistical differences for the left hand but not the right hand in the neuropathic group ( = 0.05). No other quantitative data on warm/cool or cold or vibration demonstrated sensory differences between the groups. : Few differences in sensory profiles measured using quantitative sensory testing (QST) were found. Heat pain thresholds were normalized, possibly suggesting that the neuropathic group retained C-fiber and transient potential vanilloid 1 (TRPV1) function. Participants with neuropathic pain demonstrated significant differences with increased pain and decreased function.
本研究的目的是在乳腺癌人群中确定紫杉烷诱导的周围神经病变（TIPN）在神经性和非神经性症状之间的感觉表型，以确定基于机制的疼痛管理的未来靶点。：I-III期乳腺癌患者（n = 48）。使用自我报告问卷和定量感觉测试来评估感觉症状。利兹神经病变症状和体征评估的自我报告版本（S-LANSS）将这些组分为神经性和非神经性感觉表型。总共约8个月内进行5次访视，对每位参与者从化疗前到化疗后6个月进行评估。：在191次神经评估中，150次S-LANSS<12被定义为“非神经性”，41次得分>12，被定义为“神经性”。数字疼痛评分量表（NPRS）根据经历1+疼痛（分级为1/10或更高）与无疼痛的百分比进行分析。神经性组有82.9%的人经历1+疼痛，而非神经性组为28.7%（优势比 = 7.49；95%置信区间，2.76 - 20.3；P = 0.001）。神经性组在手臂、肩部和手部功能障碍（DASH）问卷上报告功能受损（P = 0.002）。神经性组左手的热痛阈值有统计学差异，而右手没有（P = 0.05）。在温暖/凉爽或寒冷或振动方面，没有其他定量数据显示两组之间存在感觉差异。：使用定量感觉测试（QST）测量的感觉特征几乎没有差异。热痛阈值正常化，可能表明神经性组保留了C纤维和瞬时受体电位香草酸亚型1（TRPV1）功能。患有神经性疼痛的参与者在疼痛增加和功能下降方面表现出显著差异。
